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This was our response to a local MP’s attempt to push her party’s agenda in a newspaper article in the Bristol Evening Post. Her original article is below our letter to the Post published on Monday 25th March. It may sound trivial, but we need to get our views out there in every possible outlet in order to counter the drip drip of lies and half truths from the coalition government on the radical and deeply destructive changes they are making to our NHS.

CONSERVATIVE MP, Charlotte Leslie, (On The House The Post March 15) should be slightly less disingenuous.

While we are delighted to see her using your paper to inform us of how active she is as a local MP – tabling a motion “calling on NHS Executives to resign” and securing an all day debate on “transparency and accountability in the NHS” -we should not be blind to the fact that she is pushing her party’s health agenda. The truth is that whatever mistakes the Labour government made, it rescued a desperately run down NHS from a decade of underfunding and turned it round.

It wasn’t Labour who brought in managers, but the previous administration.

Labour created targets in order to bring down waiting times and by 2007 patient satisfaction was at its highest.

No one denies that standards of care in some wards at Mid Stafford were abysmal, but headlines screaming wildly varying mortality statistics do not help especially as their accuracy has been disputed by statistical analysts and health academics.

The new start she calls on for ‘our’ NHS is Andrew Lansley’s convoluted mess supported by a tiny minority of GPs and which leaves the door wide open to private operators whose motive is profit not patients.

Protect Our NHS recognises the need for continual reform of the NHS but, like thousands of health professionals, rejects the current attempts to privatise it.

From April 1 we will see changes that will lead to the end of the current NHS system. We will witness the creation of a two-tier structure with the poor and needy being forced to pay for essential services and those who can afford it taking out US style health insurance.

Mike Campbell

Protect Our NHS

And now the article from Charlotte Leslie, Conservative MP for Bristol North West

SELDOM has the phrase “deadly silence” been more apt. In Bristol, we know about things going wrong. With the baby heart scandal, years of inaction and suppression of those who voiced concern led to the most heartbreaking of tragedies.

Then there was Mid-Staffs. A few weeks ago, I tabled a motion for David Nicholson, chief executive of the NHS, and anyone else found negligent of patient care across the Department of Health or the NHS to go.

Last week I secured an all-day debate on transparency and accountability in the NHS, which I led yesterday.

My father has been a surgeon in the NHS for 30 years. His dedication and those of his fellow medics has always been an inspiration to me.

The vast majority of our doctors and nurses are excellent, dedicated professionals, who are in the job not to meet Government targets or please managers, but to treat patients.

But the revelation earlier this month in the Francis Report of what happened at Mid-Staffs forced the political class to face some uncomfortable truths about the reality of some aspects of our NHS. Until that point, it had been almost taboo to suggest that the NHS was anything but “The envy of the World”.

Even campaigners like Julie Bailey, who led the group who uncovered what was going on at Mid-Staffs were dismissed by David Nicholson as “simply a lobbying group”.

This is the “deadly silence”.

But the Francis report was tragic for yet another reason. It wasn’t news. Many of the elements of Mid-Staffs had been warned about before, and many doctors and nurses had been trying to voice their concerns at the effects a target and management culture was having on patient care.

Back in 2008, the then Labour government commissioned three reports to celebrate the NHS’s 60th birthday.

They made uncomfortable reading. They said, among other things: “The NHS has developed a widespread culture more of fear and compliance,” which put targets above patient care; “Far too many managers and policy leaders in the NHS are incompetent, unethical, or worse.”

But instead of publishing and acting upon these reports with all urgency, The Labour government buried them. They were only dug up through a Freedom of Information Request in 2010.

Now no one can be precise about how many lives might have been saved had these reports been acted upon but the excess mortality numbers across 15 trusts under investigation is 2,800 from the time the report was presented to ministers, and when it came to light in 2010.

So who was responsible for ignoring these warnings, with grave consequences? David Nicholson? Labour ministers? Whoever it is should be held accountable.

The NHS is a huge organisation. In reality it is the case that sometimes things will go wrong. But the crime is that when things did go wrong, instead of the focus being immediately to tackle it, the priority was to cover up any truth that was uncomfortable for ministers and chief execs. Dispatch-box appearance mattered more than the reality of patient lives.

Whistle-blowers and patients groups were left screaming into a vacuum, often at great personal cost. But if responsibility and accountability is to mean anything more than just words, those at the top, like David Nicholson, who oversaw the NHS’s darkest days, must go. We must be brave. There must be a cultural clean-out if we are to have any hope this will never happen again. The culture of silence must end. We need a new start for our NHS.

Below is a blog written by Mike, a 38 Degrees member in Bristol. Mike and other local 38 Degrees members, with support from local GPs, have recently convinced the Bristol CCG to adopt some important amendments into their constitution that will protect local NHS services from dangerous privatisation.

Back in November 2012, some fifty local 38 Degrees members met the Board of Bristol, North Somerset and South Gloucestershire Primary Care Trust (BNSSG). We were there to hand in a petition of over 5000 names urging the trust to do all they can to protect local NHS services by incorporating the suggested 38 Degrees amendments.

Four members of our group had a further meeting with Bristol CCG, to force home our arguments regarding the constitutional amendments, and we felt that we were listened to. Yet, when we saw the first draft of the constitution we discovered that no amendments had been made to the NHS CCG Board model constitution. We know that the CCG was under pressure to proceed with authorisation and felt that it had consulted sufficiently. However, the CCG’s goodwill and apparent wish to acknowledge our petition had not been translated into the written word.

So, in early January we commenced a second level campaign which involved emailing every GP practice in Bristol. This was supported by a number of practices who’d already been contacted by group members and a few GPs who are themselves members of 38 Degrees. A number of GP practices felt, like us, that there’d been insufficient consultation about the constitution. This campaign action had its desired effect, prompting a flurry of correspondence between the CCG and GP practices.

Then, mid-February, with authorisation in its final stages, we received a letter from the CCG providing us with a revised version of the constitution. It included, in full, the very important amendments detailed in Schedule E – success!

A number of the other amendments had not been included though and after further clarification, we received an email from the CCG assuring us that: “we are working on our mission and values again to update them. We will be consulting on them in the Spring”. Our group has decided to attend every CCG meeting from now on to hold them to this.

We’ve come far since our first 38 Degrees get-together in October last year, getting doctors on side and persuading Bristol CCG to accept some important amendments to their commissioning policy. We’ve written to local MPs and councillors, and established links with national groups to rally support against NHS privatisation. We feel that we are halfway there and our impression is that the CCG is listening. We know that many local GPs, like thousands of other health professionals and clinicians, support the 38 Degrees campaign. Regarding the amendments that have not yet been included in the revised constitution, we have been promised a response at the CCG’s next meeting in April. Let’s see what happens.

Some of us are trying to see what is going on inside the system. Two of my colleagues attended separate meetings this week. These are their brief reports, but it’s enough to make you weep and it makes it entirely clear how the government is able to push through so much so fast. How? Because (in the words of the great Hollywood scriptwriter, William Goldman, about Hollywood executives): “Nobody knows anything!”

“I attended the final Local Involvement Network meeting this week (it becomes HealthWatch from April) and several members expressed concern that they hadn’t achieved anything over the last 5 years. The funding that should have been available didn’t materialise, 5 volunteers were trained to undertake visits into hospitals and this year only one visit was undertaken. They also complained about not having information or any understanding of the the health reforms which made me prompt the question ‘How can it be that the people who are in the system don’t know anything about it and feel so dis-empowered? How does Jo public make any sense of what is going on if you don’t know ?'”

And from another colleague who went to a Patient Participation Group meeting at his local surgery – and by the way our local CCG-in-waiting is claiming this is where all the patient involvement will come from:

I attended the PPG last evening. It was an interesting
experience and somewhat alarming in that the entire
meeting agenda was focused on very local patient
surgery issues. These ranged from redecoration of
waiting rooms, the removal of toys for H&S reasons,
to some patient feedback on service provision
from the practice. The only time any mention was
made about the forthcoming legislation was a
comment about Specsavers being given a National
remit to provide hearing aids and the possible
on-costs for GPs. The meeting itself was well
chaired but the 15 or so members seemed to
have no questions about the future. I came
away wondering if they were naive, ill-informed
or not wanting to raise the spectre of
reorganisation."

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There has been a fascinating discussion on a blog – http://skwalker1964.wordpress.com/2013/02/26/the-real-mid-staffs-story-one-excess-death-if-that/about the manipulation of statistics in the Mid Staffs story and whether or not there have been between 400 and 1,200 additional and unnecessary deaths. The argument has been going on for some time with those agreeing with the figures tending to quote from Daily Mail or other sources for their legitimisation. I sent the blog to a local GP of my acquaintance and he said this:

The central thesis that the Hospital Standardised Mortality Ratios are a relative guide only, cannot demonstrate real numbers and are highly vulnerable to a whole series of biases is very convincing and has been echoed in recent BMJ editorials

I am quite certain that the 400 – 1200 deaths are political not real numbers and are part of policy to discredit the NHS – a campaign being led by the government, the BBC (especially the Today programme) and, sadly, most of the press

The real scandal is that poor care was demonstrated in Mid-Staffs – and I don’t think that this can be denied. Some criticisms were most dubious such as the drinking out of of a flower vase story – flowers have been banned from wards for decades and confused elderly patients do strange things even with the best of care. It is also extremely unfair to site the evidence of bereaved relatives as proving poor care. That is not to say that patients opinions do not matter, but their essentially subjective nature must make interpretation difficult

This poor care has a multitude of causes – to mention just a few:

Chronic current spending underfunding

Insistence on high bed occupancy

Obsession with targets

Central government control with micro- management

Government inspired management reform (since the 80’s) that has seen management at loggerheads with clinicians

Nurse training changes in association with the employment of poorly trained “health care assistants” – under the umbrella of that appalling term “skill mix”

Lack of investment in NHS IT that results in poor performance stats

Overbearing management that either refuses to listen or tries to gag dissenting voices

All these things apply to all the NHS. Mid Staffs was probably worse than most but not nearly as bad as has been made out. It is being used as a scapegoat and as a way of justifying the privatisation agenda.

Summary of successive governments’ policies:

We have a great model in the NHS which on the whole works extremely well. We have, however, deliberately tried to undermine over the years with a whole series of right wing inspired so called reforms. We have finally got to the stage that we have almost persuaded the population that their most precious possession is falling apart so that we should sell it off to the private sector. So ends the great model and one of the last vestiges of the post war social contract.

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It is worth fighting the battle against government diktats. Too many Clinical Commissioning Groups (including mine) have been supine in their acceptance of central authority. This article demonstrates that local democracy can begin to make an impact. It is vital to keep this fight going as, once local CCGs realise that patient and public intervention is going to continue, they will have to step out from behind the reams of paper filled with mangled managerial jargon, which they build into protective walls around them, and face the fact that it is OUR NHS and not theirs.

From the journal Pulse

CCGs attempt to limit use of AQP in their constitutions

28 February 2013 | By Jaimie Kaffash

Exclusive Two CCGs have incorporated a clause in their constitutions that requires them to consider alternatives to Any Qualified Provider and look at the ethical behaviour of providers before making commissioning decisions.

Bristol and Hackney CCGs have included a clause in their contract that calls on decision makers to consider ‘whether the use of approved lists is the most appropriate means of appointing providers’.

Rebecca Haynes, a barrister at Monckton Chambers who advised 38 Degrees, said that AQP was not the only route open to CCGs.

She said: ‘If European procurement rules apply, AQP might be one route they choose to go down. But they are not required to go down that route and it is not unlawful if they decide not to.’

The constitutions also compel them to take the ethical behaviour into account when appointing providers, saying all providers should be ‘good employers’, ‘respect the environment’ and not be involved in tax avoidance schemes.

The clauses have been developed by lawyers working with the NHS pressure group 38 Degrees. They state: ‘[The CCG] shall, wherever possible and where it is consistent with legal requirements, ensure that contractual provisions, procurement procedures and selection and award criteria are designed to ensure that contractors and providers are…reputable in their standards of business conduct.’

‘We will, in relation to each purchasing decision concerning health care and social services…give consideration to whether the use of a framework agreement, including the use of approved lists, is the most appropriate means of appointing providers.’

‘[The CCG] shall, wherever possible and where it is consistent with legal requirements, ensure that contractual provisions, procurement procedures and selection and award criteria are designed to ensure that contractors and providers are…reputable in their standards of business conduct.’

Dr Anna Livingstone, a GP in East London, said the clauses would help address fears over the pressure to open up services to competition

She told Pulse: ‘GPs locally have bought in to the idea of why CCGs should adopt this clause. We are extremely worried that competitive commercial pressures will interfere with the quality of healthcare. This is the standard that should be taken locally.

‘There are concerns that private providers may appear to offer cheaper options and when those cheaper options come along, because there is a profit involved, there is not money available for services available for patients. The CCGs are entirely right to have this commitment to these provisions.’

I have just seen this as a tweet. Although it’s off subject and out of date I think it says a great deal about the behaviour of the present government in relation to where it is trying to take the country. And this from a Conservative too…

“A lie gets halfway around the world before the truth has a chance to get its pants on”
– Winston Churchill

As a Conservative I have no pleasure in exposing David Cameron’s deficit claims. However, as long as the party continues to talk down the economy via the blame game, confidence will not be given an opportunity to return. For it is an undeniable and inescapable economic fact: without confidence and certainty there can be no real growth.

Below are the three deficit claims – the mess. The evidence comes from the IMF, OECD, OBR, HM Treasury, ONS and even George Osborne. The claims put into context are:

CLAIM 1The last government left the biggest debt in the developed world.

After continuously stating the UK had the biggest debt in the world George Osborne admits to the Treasury Select Committee that he did not know the UK had the lowest debt in the G7? Watch: Also, confirmed by the OECD Those who use cash terms (instead of percentages) do so to scare, mislead and give half the story.

Its common sense, in cash terms a millionaire’s debt would be greater than most people. Therefore, the UK would have a higher debt and deficit than most countries because, we are the sixth largest economy. Hence, its laughable to compare UK’s debt and deficit with Tuvalu’s who only have a GDP/Income of £24 million whilst, the UK’s income is £1.7 Trillion.

Finally, Labour in 1997 inherited a debt of 42% of GDP. By the start of the global banking crises 2008 the debt had fallen to 35% – a near 22% reduction page 6 ONS Surprisingly, a debt of 42% was not seen as a major problem and yet at 35% the sky was falling down?

CLAIM 2Labour created the biggest deficit in the developed world by overspending.

Firstly, the much banded about 2010 deficit of over 11% is false. This is the PSNB (total borrowings) and not the actual budget deficit which was -7.7% – OBR Economic and Fiscal Outlook March 2012 page 19 table 1.2

Secondly, in 1997 Labour inherited a deficit of 3.9% of GDP (not a balanced budget ) and by 2008 it had fallen to 2.1% – a reduction of a near 50% – Impressive! Hence, it’s implausible and ludicrous to claim there was overspending. The deficit was then exacerbated by the global banking crises after 2008. See HM Treasury. Note, the 1994 deficit of near 8% haaaaaah!

Thirdly, the IMF have also concluded the same. They reveal the UK experienced an increase in the deficit as result of a large loss in output/GDP caused by the global banking crisis and not even as result of the bank bailouts, fiscal stimulus and bringing forward of capital spending. It’s basic economics: when output falls the deficit increases.

Finally, the large loss in output occurred because the UK like the US have the biggest financial centres and as this was a global banking crises we suffered the most. Hence, the UK had the 2nd highest deficit in the G7 (Not The World) after the US and not as a result of overspending prior to and after 2008- as the IMF concur.

CLAIM 3Our borrowing costs are low because the markets have confidence in George Osborne’s austerity plan and without it the UK will end up like Greece.

Yes, the markets have confidence in our austerity plan and that’s why PIMCO the worlds largest bond holder have been warning against buying UK debt.

The real reason why our borrowing costs have fallen and remained low since 2008 is because, savings have increased. As a result, the demand and price for bonds have increased and as there is inverse relationship between the price of bonds and its yield (interest rate) the rates have fallen. Also, the markets expect the economy to remain stagnate. Which means the price for bonds will remain high and hence, our borrowing costs will also remain low.

Secondly, the UK is considered a safe heaven because, investors are reassured the Bank of England will buy up bonds in an event of any sell off – which increases the price of bonds and reduces the effective rate. Note, how rates fell across the EU recently when the ECB announced its bond buying program. Thirdly, because, we are not in the Euro we can devalue our currency to increase exports. Moreover, UK bonds are attractive because, we haven’t defaulted on its debt for over 300 years.

David Cameron would like people to believe the markets lend in the same way as retail banks lend to you and I.

Overall, when the facts and figures are put into context these juvenile deficit narratives and sound bites (“mere words and no evidence”) simply fail to stand up to the actual facts. The deficit myth is the grosses lie ever enforced upon the people and it has been sold by exploiting people’s economic illiteracy.

So, David Cameron when are you going to apologise?

Cameron is playing the blame game to depress confidence and growth to justify austerity. Secondly, to use austerity as justification for a smaller state to gain lower taxes. Thirdly, to paint Labour as a party that can not be trusted with the country’s finances again. Therefore, we Conservatives will win a second term because, people vote out of fear. The latter strategy worked the last time in office (18 years) and will work again because, in the end, elections are won and lost on economic credibility. Hence, as people believe Labour created the mess they won’t be trusted again.

Finally, as the truth is the greatest enemy of the a lie I urge you to share this on Facebook, Twitter, blogs, text and email etc etc. So the truth can be discovered by all. Finally, have no doubt, people have been mislead by the use of the following strategy:

“If you tell a lie big enough and keep repeating it, people will eventually come to believe it” Joseph Goebbels